Can LASIK Make Dry Eye Worse? A Detailed Look at Causes, Risks, and Prevention

Dry eye syndrome and LASIK surgery share a well-recognized relationship that many prospective patients are curious about. For most people, temporary dry eye after LASIK is a normal part of the healing process. However, for individuals with pre-existing dry eye or certain risk factors, understanding how LASIK interacts with the tear system is crucial for making an informed decision about treatment. This article explores whether LASIK can worsen dry eye, why it happens, and how best to prevent and manage it.

How the Tear System Supports the Eye

The tear film coats the cornea and has three layers: oily, watery, and mucin. Together, these layers lubricate the surface, maintain optical clarity, and protect against infection. Even small disturbances in the tear film can lead to dryness, blurry vision, or discomfort.

Since LASIK alters the corneal structure, anything that disrupts tear production or tear stability can influence visual outcomes and healing comfort.

Does LASIK Cause or Worsen Dry Eye?

The short answer is: LASIK can temporarily worsen dry eye symptoms in many patients, although the severity varies widely. The main reason involves the corneal nerve network. These nerves stimulate blinking and tear production, ensuring the eye remains moist. During LASIK, nerve fibers are cut during flap creation, causing a temporary decline in tear signaling. This phenomenon can lead to dryness for several weeks or months while nerve function gradually returns.

For most people, this dry eye phase improves and eventually resolves. In a smaller percentage of patients — particularly those with pre-existing tear disorders — dryness may be more noticeable or prolonged.

Identifying High-Risk Patients

LASIK surgeons place strong emphasis on pre-operative evaluation to identify patients more prone to persistent dry eye. Risk factors include:

• Chronic dry eye disease
• Rheumatoid arthritis or Sjögren’s syndrome
• Diabetes
• Long-term contact lens intolerance
• Meibomian gland dysfunction
• Menopause or hormonal therapy
• Smoking and dehydration habits

Patients with these characteristics may still be eligible for refractive surgery, but alternative procedures may offer better outcomes for comfort.

Alternative Surgical Options

For individuals with greater susceptibility to dry eye, alternatives to LASIK may be recommended. Two common alternatives include:

• PRK (Photorefractive Keratectomy) — Involves no flap creation, reducing nerve injury but requiring a longer healing phase.
• SMILE (Small Incision Lenticule Extraction) — Uses a keyhole-style incision, preserving more corneal nerves and lowering dry eye incidence.

These procedures demonstrate how evolving technology continues to improve patient comfort and broaden refractive options.

Pre-Treatment Strategies

One of the most effective ways to reduce LASIK-related dry eye symptoms is to treat dryness before surgery. Surgeons may prescribe:

• Warm compress therapy
• Prescription anti-inflammatory drops
• Punctal plugs
• Omega-3 supplementation
• Eyelid hygiene routines

By stabilizing the tear film prior to surgery, postoperative comfort and healing can greatly improve.

Post-Surgery Symptom Management

If dry eye occurs after LASIK, several therapeutics may be recommended:

• Frequent non-preserved artificial tears
• Nighttime lubricating ointments
• Moisture chamber goggles
• Thermal pulsation therapy for gland function
• Autologous serum tears for severe cases

Lifestyle changes — such as increased hydration, limiting screen strain, and reducing exposure to dry air — can also help support recovery.

Long-Term Prognosis

Most LASIK patients do not experience long-term dry eye complications and achieve excellent visual outcomes once healing completes. The key to success lies in proper screening, personalized treatment plans, and open communication regarding symptoms and expectations.

Bottom Line

LASIK and dry eye are connected primarily through nerve-related tear production changes. Although LASIK can temporarily worsen dryness, most symptoms are manageable and often resolve completely. With modern screening, advanced technologies, and improved postoperative care, LASIK continues to be a safe and rewarding vision correction option for a wide range of patients.

Sohaib is a technology enthusiast and writer specializing in blockchain and Web3 development. With a passion for innovation, they help businesses leverage cutting-edge software solutions to achieve success in the digital era.